WTNJ Artist Information

Thank you for working with us! Please fill out the information on this form below. All items with asterisks are required fields. If you have any questions please e-mail John Pietrowski at JPietrowski@wtnj.org .

Step 1 of 3 - Basic Information

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First Name (Business)*

Your name as it appears on your tax forms.

Last Name (Business)*

Your last name as it appears on your tax forms.

Middle Initial (Business)

Middle Initial if it appears on your tax forms. (not required)

Social Security Number

Enter numbers with no spaces or hyphens

Member AEA?*

AEA

EMC

Non-AEA

Union Affiliations

Check all that apply

AEA

SAG/AFTRA

SSDC

AEA/EMC

Other

How your name should appear in the program.*

Address 1*

Your street address. Where you want your check to go.

Address 2

Apt. Number, etc.

Municipality*

City, Town, etc.

State*

Zip Code*

Cell Phone or Primary Phone*

Enter numbers without spaces or punctuation.

Cell phone?*

Is the phone above a cell phone number?

Yes

No

Texts*

Can you receive texts on your cell?

Yes

No

Not applicable

Home Phone

Enter numbers without spaces or punctuation.

Work Phone

Enter numbers without spaces or punctuation.

E-mail 1*

Your primary e-mail. Required field.

E-mail 2

Secondary e-mail (not required)

Website

Please enter a short bio for the program (250 character max)

Emergency Contact Name*

Emergency Contact Phone*

Agency Representation

Company and Agent Name

Food and Health Needs.

Food and medicine allergies, other special circumstances.

Transportation

Let us know how you will be coming to rehearsal/performance.

Driving

Train

In car, passenger

Other

Car Information*

Did we specifically request that you provide information on your car (e.g., make, model, license plate)?

Yes

No

License Plate Number*

If a rental or not your car, write N/A

State*

State on License (if rental or not your car, write N/A)

Make of Car*

If a rental or not your car, write N/A

Model of Car*

If a rental or not your car, write N/A

Color of Car*

If a rental or not your car, write N/A

Year of Car

If a rental or not your car, write N/A

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